RCM Collection Specialist

Eastvantage Group; Quezon City; On-site; PHP 279,000 - 446,000; Full time

Job summary

Eastvantage Group is seeking a Collection Specialist in the Philippines to bridge the billing department and third-party payers, ensuring accurate billing and steady collections for a healthcare organization. The role reports to the Director of Collection.

You will monitor overdue accounts, communicate with payers and customers, analyze trends in denials, and apply CPT/ICD-10 coding to optimize billing accuracy and timely payment collection.

Qualifications

• Minimum 2 years of experience in RCM or collections.
• Strong analytical and problem-solving skills.
• Excellent communication and negotiation abilities.
• Proficiency with billing software and MS Office tools.

Responsibilities

• Monitor accounts to identify overdue payments and correct errors in previously submitted claims to ensure full payment
• Clearly communicate with team members, third-party payers, and customers regarding identified claims errors via phone and email
• Identify, analyze, and research trends in claims rejections and partial payments to create resolutions
• Prioritize activities to work denials and partial payments in a timely manner to avoid timely filing limitations
• Leverage reporting tools for comprehensive data analysis, creating targeted action plans to resolve billing issues
• Utilize coding systems (CPT, ICD-10) to guarantee meticulous billing and collections
• Process and reprocess medical claims in accordance with payer regulations, protocols, medical authorizations, and departmental guidelines

Skills

Analytical thinking

Problem solving

Excellent communication

Negotiation

Independent and collaborative

Tools

Billing software

MS Office

Job description

As Collection Specialist, you will serve as a bridge between the billing department and third-party payers to resolve overdue claims and collect payments. In this role, you will be responsible for ensuring accurate billing and efficient collections processes within our healthcare organization. This position will report to the Director of Collection

What You'll Do

• Monitor accounts to identify overdue payments and correct errors in previously submitted claims to ensure full payment
• Clearly communicate with team members, third-party payers, and customers regarding identified claims errors via phone and email
• Identify, analyze, and research trends in claims rejections and partial payments to create resolutions
• Prioritize activities to work denials and partial payments in a timely manner to avoid timely filing limitations
• Leverage reporting tools for comprehensive data analysis, creating targeted action plans to resolve billing issues
• Utilize coding systems (CPT, ICD-10) to guarantee meticulous billing and collections
• Process and reprocess medical claims in accordance with payer regulations, protocols, medical authorizations, and departmental guidelines

What We're Looking For

• Minimum 2 years of relevant experience in RCM or collections
• Strong analytical and problem-solving skills
• Excellent communication and negotiation abilities
• Proficiency with billing software and MS Office tools
• Ability to work independently and collaboratively